Surgical Management of Cervical Spondyloarthropathy in Hemodialysis Patients

Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy. Optimal management of cervical spine spondyloarthropathy often requires circumferential reconstructive surgery, because affected patients typically have both the anterior column and the facet joints compromised. The occasional presence of noncontiguous or "skip lesions" adds an additional level of complexity to surgical management, because decompression and fusion in an isolated segment of neural compression can worsen spine deformity by applying increased stress to adjacent cervical spine segments. We report two cases of hemodialysis patients who presented with cervical myelopathy and initially had anterior cervical discectomy or corpectomy. Because symptoms recurred due to hardware failure, both patients required posterior spine fusion as well. In retrospect, because of the hardware failure, both of these patients might have benefited from a circumferential (combined anterior and posterior) cervical spine reconstruction as their initial treatment

Ninety-Degree Chevron Osteotomy for Correction of Hallux Valgus Deformity: Clinical Data and Finite Element Analysis

Hallux valgus is a very common foot disorder, with its prevalence estimated at 33% in adult shoe-wearing populations. Conservative management is the initial treatment of choice for this condition, but surgery is sometimes needed. The 600 angle Chevron osteotomy is an accepted method for correction of mild to moderate hallux valgus in adults less than 60 years old. A modified 900 angle Chevron osteotomy has also been described; this modified technique can confer some advantages compared to the 600 angle method, and reported results are good. In the current work we present clinical data from a cohort of fifty-one female patients who had surgery for sixty-two hallux valgus deformities. In addition, in order to get a better physical insight and study the mechanical stresses along the two osteotomies, Finite Element Analysis (FEA) was also conducted. FEA indicated enhanced mechanical bonding with the modified 900 Chevron osteotomy, because the compressive stresses that keep the two bone parts together are stronger, and the shearing stresses that tend to slide the two bone parts apart are weaker, compared to the typical 600 technique. Follow-up data on our patient cohort show good or excellent long-term clinical results with the modified 900 angle technique. These results are consistent with the FEA-based hypothesis that a 900 Chevron osteotomy confers certain mechanical advantages compared to the typical 600 procedure

Vitamin D Deficiency in Orthopedic Patients in Different Latitudes—First Study Comparing German and Greek Populations

Vitamin D plays a pivotal role in calcium metabolism and bone mineralization. Sufficient vitamin D levels are important for the health and functionality of the musculoskeletal system. Hypovitaminosis D is a phenomenon affecting orthopedic patients worldwide. This study researched whether most orthopedic patients in two different cities of different countries had hypovitaminosis D, whether there was a correlation between sunshine hours and vitamin D serum levels, and whether hours of sunshine alone were enough to achieve vitamin D sufficiency among orthopedic patients regardless of their activities. The vitamin D serum levels of 500 orthopedic patients in Regensburg and 500 in Patras were assessed, in addition to their medical histories. The mean sunshine hours throughout the year were also calculated. Both the German and Greek groups showed hypovitaminosis D. Older patients were more affected. Although there were more hours of sunshine in Greece, Greek orthopedic patients also showed hypovitaminosis D. Hypovitaminosis D affects orthopedic patients independent of their latitude. Supplementation of vitamin D may be considered among orthopedic patients to achieve sufficient levels in serum. Sufficient vitamin D levels may be helpful for the treatment of orthopedic patients, reduce the negative effects of operations or postoperational settings

Vitamin D Deficiency in Orthopedic Patients in Different Latitudes—First Study Comparing German and Greek Populations

Vitamin D plays a pivotal role in calcium metabolism and bone mineralization. Sufficient vitamin D levels are important for the health and functionality of the musculoskeletal system. Hypovitaminosis D is a phenomenon affecting orthopedic patients worldwide. This study researched whether most orthopedic patients in two different cities of different countries had hypovitaminosis D, whether there was a correlation between sunshine hours and vitamin D serum levels, and whether hours of sunshine alone were enough to achieve vitamin D sufficiency among orthopedic patients regardless of their activities. The vitamin D serum levels of 500 orthopedic patients in Regensburg and 500 in Patras were assessed, in addition to their medical histories. The mean sunshine hours throughout the year were also calculated. Both the German and Greek groups showed hypovitaminosis D. Older patients were more affected. Although there were more hours of sunshine in Greece, Greek orthopedic patients also showed hypovitaminosis D. Hypovitaminosis D affects orthopedic patients independent of their latitude. Supplementation of vitamin D may be considered among orthopedic patients to achieve sufficient levels in serum. Sufficient vitamin D levels may be helpful for the treatment of orthopedic patients, reduce the negative effects of operations or postoperational settings